Can aspirin really lower risk of cancer?

Leading cancer specialist and medical director of CancerPartnersUK, Professor Karol Sikora, asks if aspirin is really a magic bullet for cancer.

A recent study on the role of aspirin as a cancer preventive raises many issues: who to give it to, how does it work, what dose, how to prevent side effects and is it worth it?

We already have the potential for effective cancer chemoprevention, thanks to specific drugs such as tamoxifen for breast cancer and finasteride for prostate cancer.

But common to the various cancers is their association with inflammation with several inhibitors available that are already in clinical use as anti-inflammatory painkillers, including aspirin.

The Oxford University study showed that an aspirin a day will reduce the chances of colon cancer by about 40%, lung cancer by 30%, oesophageal cancer by 60%, and prostate cancer by 10%.

The use of less toxic, more potent, anti-inflammatory agents in high-risk individuals could have an enormous impact on cancer incidence, but blanket approaches to prevention are tedious for both participants and investigators.

What is amazing that less than 2% of the total cancer research budget is spent on prevention.

Comparison of aspirin in cancer prevention with the development of cholesterol-lowering agents – the statins – is interesting. Patients at high risk of heart attacks and strokes are identified by their cholesterol level, given a statin and their cholesterol level measured a month later.

But for cancer risk, we still have nothing to measure.

Genetic mapping will reveal which people carry a predisposition to certain diseases and this individualisation of risk, biomarkers of risk and effective tailored prevention will be the future of cancer care - for those lucky enough to afford it.